Description: Carol McCall led three teams – predictive analytics, health economics and outcomes research, and personalized medicine. The “river running through them” was that they all leveraged data. Her predictive analytics team eventually built a broad portfolio of models with some of them having a significant impact on Humana’s top and bottom lines.

Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: Data is everywhere. Health care generates as much as 30% of the world’s data, and new technologies are changing how life insurers analyze consumer information. Actuaries are business-savvy problem solvers. They understand how to leverage the latest technologies and techniques to turn data into actionable insights and solutions for businesses and can communicate those findings to multiple audiences. SOA-credentialed actuaries use predictive analytics to inform organizational and business strategies, with efforts such as identifying chronic conditions in their early stage or determining stress levels through sweat patterns.